Menstruation Requirements: A Significant Barrier to Contraceptive Access in Developing Countries

Stanback, John; Thompson, Andy; Hardee, Karen; Janowitz, Barbara

doi:10.2307/2137892

Cited by 44 publications

(21 citation statements)

References 4 publications

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“…Our findings are supported by evidence from Ghana, Kenya, Cameroon, Jamaica, and Senegal indicating that nonmenstruating women are commonly told they must return when they are menstruating in order to be given a hormonal contraceptive method or to have an intra-uterine device (IUD) inserted [23]. One rationale offered to justify these requirements is that it is cheap and there is no need to do pregnancy tests.…”

Section: Barriers To Use and Discontinuation Of Contraceptionsupporting

confidence: 68%

Barriers affecting utilization of family planning services among rural Egyptian women

Em¹,

Ne²,

Aa³

2013

East Mediterr Health J

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Section: Barriers To Use and Discontinuation Of Contraceptionsupporting

confidence: 68%

Barriers affecting utilization of family planning services among rural Egyptian women

Em¹,

Ne²,

Aa³

2013

East Mediterr Health J

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“…Clients who arrive past their scheduled follow-up injection date may be denied reinjection and asked to return during their next menses, to ensure that they are not pregnant. 7 Besides being an unnecessary burden for women who may have trouble reaching clinics, the "with-menses" management approach for late clients is particularly problematic for women who may wait up to six months or longer for their menses to return due to the unpredictable physiological effects of injectables. 8 Women seeking reinjection who are turned away may receive little or no counseling about interim contraceptive protection.…”

mentioning

confidence: 99%

Timeliness of Contraceptive Reinjections in South Africa And Its Relation to Unintentional Discontinuation

Baumgartner

Morroni²,

Mlobeli³

et al. 2007

IFPP

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“…1 Providers worry that contraception can harm unrecognised pregnancies, but in doing so ignore the risks run by clients who leave the clinic without effective contraception. This widespread problem stems from the unavailability of pregnancy tests and providers' unwillingness or inability to effectively use a client history to rule out pregnancy.…”

mentioning

confidence: 99%

Does assessment of signs and symptoms add to the predictive value of an algorithm to rule out pregnancy?

Stanback

Nakintu²,

Qureshi³

2006

j fam plann reprod health care

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Background A World Health Organization-endorsed algorithm, widely published in international guidance documents and distributed in the form of a 'pregnancy checklist', has become a popular tool for ruling out pregnancy among family planning clients in developing countries. The algorithm consists of six criteria excluding pregnancy, all conditional upon a seventh 'master criterion' relating to signs or symptoms of pregnancy. Few data exist on the specificity to pregnancy among family planning clients of long-accepted signs and symptoms of pregnancy. The aim of the present study was to assess whether reported signs and symptoms of pregnancy add to the predictive value of an algorithm to rule out pregnancy.Methods Data from a previous observational study were used to assess the performance of the algorithm with and without the 'signs and symptoms' criterion. The study group comprised 1852 new, non-menstruating family planning clients from seven clinics in Kenya.Results Signs and symptoms of pregnancy were rare (1.5%) as was pregnancy (1%). Signs and symptoms were more common (18.2%) among the 22 clients who tested positive for pregnancy than among the 1830 clients (1.3%) who tested negative, but did not add significantly to the predictive value of the algorithm. Most women with signs or symptoms were not pregnant and would have been unnecessarily denied a contraceptive method using the current criteria. ConclusionsThe 'signs and symptoms' criterion did not substantially improve the ability of the algorithm to exclude pregnant clients, but several reasons (including use of the algorithm for intrauterine device clients) render it unlikely that the algorithm will be changed. G A popular algorithm for ruling out pregnancy among family planning clients subordinates six criteria predictive of nonpregnancy to one 'master criterion' based on signs and symptoms predictive of pregnancy.

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Menstruation Requirements: A Significant Barrier to Contraceptive Access in Developing Countries

Cited by 44 publications

References 4 publications

Barriers affecting utilization of family planning services among rural Egyptian women

Barriers affecting utilization of family planning services among rural Egyptian women

Timeliness of Contraceptive Reinjections in South Africa And Its Relation to Unintentional Discontinuation

Does assessment of signs and symptoms add to the predictive value of an algorithm to rule out pregnancy?

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